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Radiologist Second Opinion for MRI

Spine Health | Last Active: Mar 1 1:20pm | Replies (7)

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Thank you for the welcome!

I’ve had a lot of symptom changes since I last posted and have been rendered basically unable to do much.

My chest pain is still predominant and is now a constant squeeze/ache that comes and goes throughout my entire chest with occasional sharp episodes on my left side. I’ve also started to have extreme unexplained tightness in my upper middle back and neck with new random onset migraines that have left me unable to eat or walk. All of this along with new onset pins and needles throughout my upper back and upper/lower extremities with muscle weakness throughout my body - to the point where I can’t hold my phone to my ear without having to rest my arm on something. The most recent neuro visit showed I had a positive hoffmans test and new hyperflexia in almost all reflex tests done but was brushed aside by the doctor and never explained to me.

With the episodic chest pain, after 5 months we have not been able to observe anything that typically triggers it - it seems to be very random.

I have a physical job and work in healthcare so I sit and move around a lot.

My husband is a PA - and we obtained a disc of my MRIS prior to the imaging - on our end he was able to see multiple discs in my lower lumbar that were of concern as well as places with what could be lesions and some disruption in the shape of my spinal cord near the lower Cspine. The results from the radiologist who interpreted my scans were “unremarkable with no findings” which we just cannot wrap our heads around.

I have more recently been looking into TOS and things along those lines.

Just very much struggling to find a specialist who will take me seriously and work with me and take the time to figure out what is going on. Feeling very given up on by almost every doctor I have seen since this has started.

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Replies to "Hello! Thank you for the welcome! I’ve had a lot of symptom changes since I last..."

@gjkuzmin21 Working in healthcare, I can imagine that looking at computer screens and typing in information could put you in some forward slouching posture and if you do this with your head forward and looking down would be posture that would aggravate TOS. My TOS is worse on the left side, so my neck is tighter on that side and it sets up unequal tension and can cause rotation of my cervical vertebrae with out me turning my head. If you are doing heavy lifting with patients, you may be stressing your neck by recruiting those muscles to help and if you have TOS, that would make it worse. Migraine type pain can happen because of rotation of C1 & C2 if that is happening on one side. I know when my muscles start to turn my vertebrae and I stretch it out to make it stop.

I think working with a physical therapist doing Myofascial Release can help a lot. You may be getting stuck in postures with tight fascia from the physical demands of the job. Even though there are a few things on the MRI, it may not be the main source of the pain. It could be more of a TOS issue and less of a spine issue, but it take the specialists to look and decide. My issues were spinal cord compression from a ruptured disc at C5/C6 in addition to TOS, and I had a lot of weird pain. If your issues are more about TOS, it's possible that myofascial release may help a lot. Surgery is the last resort, and it always creates scar tissue that causes tightness and can make a problem worse if it is caused by tight tissue.

Often the best doctor to read MRI imaging would be the spine surgeon because they know what they are looking for to fix instead of a radiologist. The radiologist often describes many possibilities that need further exploration because they don't want to miss something that could be important.

If you can travel to Mayo in Rochester, MN, there are specialists there for diagnosing TOS as well as spine neurosurgeons. I had my surgery there and came in with the diagnosis of TOS which was reconfirmed in the vascular lab with testing. My neurosurgeon there is excellent and he understands the relationship of TOS with spine problems because he's had me as a patient. If going to Mayo is a possibility, the first thing is to check if your health insurance is accepted at Mayo. You would be able to apply to Mayo and send in imaging discs and they will review it at no charge. If there is something wrong structurally that they could help with, you may be offered an appointment. There is a lot of competition for available appointments, but if you also wanted to ask about a possible TOS diagnosis, that may give you a better chance of getting in.

Here is Mayo's insurance information.

If you can't go to Mayo, it would be worth it to work with a good physical therapist. They can help in diagnosis because they figure out what doesn't move correctly, and they may just solve the problem. Spine issues can take several years to progress to where surgery would be needed. It was about 3 years for me from the time the spine issue became evident to when I had surgery. I had an unusual case and it was misunderstood by 5 local spine surgeons over 2 years time which is why I came to Mayo.

Here is a provider search for a therapist for myofascial release.

What do you think would be your best choice at this time?


Morning. Jennifer's suggestions are excellent. I'll just jump in and add something to your "where to go" question. I live in Upstate SC and chose Mayo JAX for diagnostics and then surgery. The 6 1/2 drive was irritating at times - but that time investment to get everything right was well worth the short inconvenience.

In NC - the folks at Duke and the Spine Institute at Emory (Atlanta) can offer excellent closer-to-you options.

Quick story? I once was being prepped in an OR for delicate brain surgery as indicated by multiple angiograms showing a physical brain anomaly. The neurosurgeon (always a good choice when working with nerves and such) decided to confirm the angiogram - as it was done by a different facility. (pick the best medical facility you can get to). This additional angiogram convinced the neurosurgeon the indicated anomaly was just an artifact (go where they have the best diagnostic equipment) and brain surgery was canceled. It's 33+ years later and I'm still good!

Wishing you the best.